CLINICAL UTILITY OF MODIFIED ALVARADO SCORE IN DIAGNOSING ACUTE APPENDICITIS

Dr. Anmol Chaudhary, Dr. J. L. Kumawat

Abstract


BACKGROUND : An infection of the appendix may occur by several reasons. Diagnostic scoring systems have been developed in an attempt to improve the diagnostic accuracy of acute appendicitis. The most prominent of those scores was that developed by Alvarado. A wrongly made diagnosis is responsible for significant mortality and morbidity. The prime goal of surgeon is removal of inflamed appendix before perforation with minimal negative appendectomies. Thus, this arises need of a method, which can complement clinical diagnosis and make clinical decision more precise and consistent.
MATERIALS AND METHOD : Patients seeking treatment in Department of Surgery for right iliac fossa pain and diagnosed acute appendicitis at GMCH, Udaipur.
RESULTS: Male to female ratio was 1.5:1. Maximum patients were in the age group of 20-29 years i.e. 33.33%. Pain abdomen (100%), Rif tenderness (96%), followed by vomiting (92%), fever (90.67%) were the predominant clinical features. Modified Alvarado score had a sensitivity of 90.74%, specificity of 38.10%, positive predictive value of 79.03%, negative predictive value of 61.54%, and diagnostic accuracy of 76%. When modified Alvarado score and ultrasonography were combined together and both were positive, sensitivity of diagnosing acute appendicitis was 90.38% in this study.
CONCLUSION: Incorporation of modified Alvarado scoring system in combination of ultrasonography for establishment of diagnosis in cases of suspected acute appendicitis surely provides higher accuracy and helps in decreasing negative appendectomies.


Keywords


appendix, Diagnostic scoring systems, Alvarado

Full Text:

PDF

Refbacks

  • There are currently no refbacks.